Ultrasound Assessment of Primary Pyomyositis in a Man with Uncontrolled Type 2 Diabetes: A Case Report

以超音波評估原發性膿性肌炎於一位未受控制第二型糖尿病男性病患：病例報告

李亞真(Ya-Chen Lee) ； 塗雅雯(Ya-Wen Tu) ； 吳韋廷(Wei-Ting Wu) ； 韓紹禮(Shao-Li Han)

《台灣復健醫學雜誌》 38卷4期 (2010/12) Pp. 247-253

https://doi.org/10.6315/2010.38(4)06

摘要

一位38歲第二型糖尿病未受控制的男性患者，因右側後大腿輕微腫痛3天而求診。最初診斷爲右側腿後肌拉傷，經過一個星期的消炎止痛藥治療後，其臨床症狀進展爲顯著的右側後大腿腫痛，並有白血球及發炎指數升高的現象。超音波顯示右側後大腿有一邊界不明、混合回音的病灶，其周圍爲厚度不規則、高回音且高血流的組織，診斷爲右側股二頭肌膿性肌炎，與後續的核磁共振檢查結果相符。病患接受切開及擴創術，及七週的抗生素治療後，復原良好並無任何後遺症。
臨床醫師應該更熟悉此一可能危及性命的疾病，且適當地使用超音波來幫助早期診斷及早期治療膿性肌炎，以降低此疾病長期併發症的產生。

關鍵字

原發性膿性肌炎 ； 超音波 ； 第二型糖尿病 ； 外傷

並列摘要

A 38-year-old man with uncontrolled type 2 diabetes mellitus complained of a mild painful swelling over the right posterior thigh that had been present for 3 days. He was initially diagnosed as having a right hamstring strain. After a 7-day treatment with non-steroidal anti-inflammatory drugs, the symptoms progressed to a prominent painful swelling over the right posterior thigh. Leukocytosis and high inflammation indices were noted. The ultrasonography of the right posterior thigh showed an ill-defined heteroechoic lesion surrounded by an irregularly thick hyperechoic and hypervascular wall in the muscle layer. The diagnosis was pyomyositis of the right biceps femoris muscle, which was compatible with the finding of a subsequent magnetic resonance imaging. Incision and debridement were performed. The patient was treated with a 7-week regimen of antibiotics and recovered well, without any significant sequelae.
Physicians should become more familiar with this potentially life-threatening disease and appropriately use ultrasound to aid in the early diagnosis and treatment of primary pyomyositis.

並列關鍵字

primary pyomyositis ； ultrasound ； type 2 diabetes ； trauma